Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | 00108702 |
NPI | 1174089288 |
---|---|
Provider Name | Joshua M. Blevins |
First Address | Columbus, OH 43216-1809 |
Second Address | Columbus, OH 43215-2815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2019 |
Last Update Date | 13/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00108702 | COMMISION ON REHABILITATION COUNSELOR CERTIFICATION (01) |